[Chronic disseminated histoplasmosis as an opportunistic infection]

Sixty four patients suffering a chronic disseminated histoplasmosis were studied with the aim of fingind if they had predisposing factors. Thirty cases (46.8%) presented the following predisposing conditions: long treatment with low doses of corticosteroids in 7, ethilic hepatopathy in 7, diabetes in 4, lymphoma in 3, epitheliomas in 3, epitheliomas and diabetes in 1, renal insufficiency in 1, toxic hepatitis in 1, radiations in 1, long treatment with psychotropics in 1 and primary combined immunodeficiency in 1. Only slight differences were detected between these two groups of patients; those who exhibited predisposing factors presented an increased number of clinical localizations, altered cell mediated immunological tests were more frequent as well as the number of patients with multiple relapses and deaths. Histoplasmosis was not the cause of death in any case. It is possible that if a more frequent aggressive exploration, as hepatic biopsy, would be done a higher number of patients with predisposing factors would have been demonstrated.